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作者

Feng Liu Jia-Lin Cheng Jing Cui Zong-Zhen Xu Zhen Fu Ju Liu Hu Tian

作者单位

Department of General Surgery；Taishan Medical University；Department of Pathology；Medical Research Center

刊名

世界临床病例杂志

年份

2019

卷号

第6期

页码

717-726

关键词

AMPULLA of VATER Ampullary neoplasm Transduodenal AMPULLECTOMY PATHOLOGICAL DIAGNOSES

分类号

R

摘要

BACKGROUND Transduodenal ampullectomy is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However, TDA is still an effective treatment method;it has great clinical value in cases of duodenal benign tumors, precancerous lesions, and benign and malignant borderline tumors, and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy. AIM To investigate the surgical meth...更多

BACKGROUND Transduodenal ampullectomy is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However, TDA is still an effective treatment method;it has great clinical value in cases of duodenal benign tumors, precancerous lesions, and benign and malignant borderline tumors, and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy. AIM To investigate the surgical method choice and the coincidence rate of pathological diagnoses in TDA for ampullary neoplasms. METHODS Ten patients with ampullary neoplasms underwent TDA based on the fact that their endoscopic biopsy results suggested benign lesions, and the endoscopic ultrasound -assessed tumors were resectable. All cases underwent duodenal ampullary lesion endoscopic biopsy, intraoperative frozen-section pathological examination, and postoperative pathological examination. RESULTS This study included seven patients with benign tumors and three with malignant tumors , according to the postoperative pathology results. The coincidence rate of the postoperative pathology results with the intraoperative frozen-section biopsy results was 100%, and the coincidence rate with the endoscopic biopsy results was 70% based on pathological characteristics. The endoscopic biopsy false-negative rate was 30%. All patients were followed for 6 to 70 mo without tumor recurrence or metastasis. CONCLUSION The coincidence rate of postoperative pathology results, intraoperative frozensection pathology results, and endoscopic biopsy results is the restraining factor of TDA clinical application. Endoscopic biopsy results and EUS have importance relevance to surgical planning. Intraoperative frozen-section pathology results have a significant influence on the choice of surgical procedure.收起

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